The National Committee on Bioethics and Technoethics (EEBT) has issued a recommendation on the priority of providing monoclonal antibodies against coronavirus, following a request from the Ministry of Health. The issue has arisen from the availability of monoclonal antibody therapy in limited doses relative to potential recipients among the confirmed cases of Covid-19.
The Commission notes that the treatment of monoclonal antibodies is appropriate only for the early stages of the disease, before the possible admission for hospitalization of the patient. Also:
– Recognizes that priority must be given to those at highest risk of serious illness.
– Proposes the use of the treatment only where there is an expectation of benefit for the health of the person and not as a means of post-exposure prophylaxis and with the condition of consent after informing the latter or when in position) of his legal representative.
– Points out that the risk is assessed in terms of severity and immediacy due to underlying diseases and based on generally accepted factors such as age, level of immunosuppression and comorbidities. The presence of more than one such factor multiplies the risk of serious disease and can be a priority criterion.
Proposes the addition of valuation indicators and numerical values to risk factors.
Proposes, where possible, that the contribution of measurable adverse social and economic factors be taken into account, which may make certain categories of patients particularly vulnerable (if left untreated), in order to avoid the aggravation of inequalities.
The Commission considers it appropriate to set up a “Central Committee for the Evaluation of the Requests of Physicians” as a means of promoting equal access to treatment. The Commission’s “within 24 hours” response, as planned, is important to follow, because the effectiveness of the intervention depends on it.
It also states that care needs to be taken to ensure equal access to patients’ monoclonal antibodies from all parts of the country, central and remote.
Finally, he clarifies that the patients who may be eligible for treatment with monoclonal antibodies are adult or pediatric outpatients (over 12 years of age and weighing over 40 kg) who have been found to be positive for the coronavirus, with mild to moderate Covid-19 symptoms in the last five days and with a serious risk of aggravation of their condition, due to various high risk factors such as transplantation, renal failure, cystic fibrosis, cancer, etc.
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